DR. JUDITH CANELLA BLAISE (NPI# 1275578130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275578130 |
| Entity Type | Individual |
| Full Name | DR. JUDITH CANELLA BLAISE |
| Credential | M.D. |
| Practice Address |
602 N Acadia Rd Thibodaux LA 70301-4823 |
| Mailing Address |
Po Box 5237 Thibodaux LA 70302-5237 |
| Practice Telephone | 9854934706 |
| Practice Fax Number | 9854492595 |
| Mailing Telephone | 9858030584 |
| Mailing Fax Number | 9854490700 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2019-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 020707 | LA | Allopathic & Osteopathic Physicians |
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
MD.020707 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1540161 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 216 Davis Dr, Thibodaux, LA 703018020 | 9858030584 | 9854490700 |
| 4600 Ambassador Caffery Pkwy, Lafayette, LA 705086902 | 3375219426 | 8448528954 |
| 501 Medical Center Dr, Alexandria, LA 713018124 | 3187697030 | 3187697897 |
| 604 N Acadia Rd, Suite 202, Thibodaux, LA 703014847 | 9854476444 | 9854490700 |
| Street Address |
602 N ACADIA RD |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-4823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467427336 | Thibodaux Regional Network Development Corporation | Radiology | 602 N Acadia Rd, Thibodaux, LA 70301-4847 | 2006-02-22 |
| 1346855715 | Lindsay A Dufresne | Physician Assistant | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2020-09-12 |
| 1598370991 | Jill L Bueche | Nurse Practitioner | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2020-09-11 |
| 1972118842 | Adele Elise Broussard | Physician Assistant | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2020-09-08 |
| 1336759737 | Nia Walker | Physician Assistant | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2020-07-31 |
| 1639705924 | Gage Duet | Student in an Organized Health Care Education/Training Program | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2020-03-18 |
| 1992352629 | Jamie Roy-daigle | Clinical Pharmacology | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2019-08-19 |
| 1356995096 | Kaley Marie Duplantis | Physician Assistant | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2019-07-31 |
| 1750933438 | Thibodaux Regional Health System Inc | Psychiatric Hospital | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2019-07-12 |
| 1740840909 | Thibodaux Regional Health System Inc | Psychiatric Hospital | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2019-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| 1982112348 | Katie Leblanc | Massage Therapist | 1115 St. Mary Street, Thibodaux, LA 70301 | 2018-01-18 |
| 1154837391 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 764 North Acadia Road, Suite A, Thibodaux, LA 70301 | 2017-12-26 |
| 1235648239 | Speech and Feeding Therapy, LLC | Speech-Language Pathologist | 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 | 2017-09-22 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1427583475 | Tyler Pettigrew | Counselor | 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 | 2017-04-27 |
| 1750825758 | Jessica Barquet | Counselor | 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 | 2016-12-09 |
| 1013468230 | Shenee Haas Gros | Counselor | 504 Cherry St., Thibodaux, LA 70301 | 2016-10-24 |
| 1982155388 | Southern Ent Associates Inc | Audiologist | 604 North Acadia Road Suite 101, Thibodaux, LA 70301 | 2016-10-20 |
| 1215483888 | Lesheeca Norman, Lpc | Counselor | 306 Victoria Court, Thibodaux, LA 70301 | 2016-09-01 |
| Find all providers in zip 70301 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184963613 | Thibodaux Regional Network Development Corporation | Obstetrics & Gynecology | 604 N Acadia Rd Ste 500, Thibodaux, LA 70301-4743 | 2013-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245572031 | Vanessa Cloutier Thibodeaux | Obstetrics & Gynecology | 4228 Houma Blvd Ste 410a, Metairie, LA 70006 | 2013-03-20 |
| 1811236136 | Kevin Ulysse Stephens Sr. | Obstetrics & Gynecology | 1 Rosedown Ct, New Orleans, LA 70131-3313 | 2013-02-06 |
| 1336381458 | Cao Care Inc | Obstetrics & Gynecology | 2924 Knight St Ste 408, Shreveport, LA 71105-2413 | 2009-04-03 |
| 1871784090 | Kristin Kymyana Green | Obstetrics & Gynecology | 5646 Read Blvd Ste 280, New Orleans, LA 70127 | 2007-08-05 |
| 1467578104 | Donald R. Parker, Md Apmc | Obstetrics & Gynecology | 4150 Nelson Rd Ste E4, Lake Charles, LA 70605-4133 | 2007-03-22 |
| 1730214214 | Catholic Charities Archdiocese of New Orleans | Obstetrics & Gynecology | 921 Aris Ave, Metairie, LA 70005-2207 | 2007-02-23 |
| 1295872992 | Alexandria Womens Center A Medical | Obstetrics & Gynecology | 3304 Masonic Drive, Suite 4001, Alexandria, LA 71301-9998 | 2007-01-31 |
| 1699812677 | Health Specialists for Women | Obstetrics & Gynecology | 10633 Doctors Boulevard, Hammond, LA 70403 | 2007-01-31 |
| 1083776868 | Michael E Graham | Obstetrics & Gynecology | 4720 S I-10 Service Road, Suite 104, Metairie, LA 70001 | 2006-12-15 |
| 1598722589 | George B Morris IIi | Obstetrics & Gynecology | 1221 So. Clearview Parkway, Harahan, LA 70123 | 2006-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.